She went into cardiac arrest in the ER in January and the team was finally able to find a pulse after 40 minutes. I was there to experience this upsetting moment in time. Nevertheless, 5 days of induced coma in cardiology ICU, 9 days on another floor and 2 weeks in rehab. What caused the CA? She has had a pacemaker for 2 years and her cardiologist ran tests that determined she had toxic levels of one of her meds that works in concert with her pacemaker. Basically, it stopped her pacemaker from doing the job it's supposed to do. So, knowing my mother's awful sleep habits over the last several years or so, I put the pieces together that she took the medication too close together. Say she went to bed at 5 am and took med at bedtime and then when she woke in the am. It is a 2X a day medication which has been stopped. She is on another. I had asked for a complete neuropsychological evaluation prior to her rehab release but neuropsychologist was only able to do a short version. He stated a complete evaluation after approximately 3 months following the event. 6-8 weeks she needs someone with her. No driving. I have 3 brothers out of state and each of us is doing rotations and helping our mother keep a "normal" eat, sleep, wake, exercise, take meds, routine. It has been challenging because she's stubborn and lives alone since our dad died from cancer back in 2009. I live 40 minutes away with my family. My oldest brother and his wife are staying with her now and they are pointing out to her that she is falling back into her old habits that led to the event. We got her a pill dispenser that sets an alarm 2 times a day. It's fine if she's in the room but her home is over 3400 square feet. She is picky about watches and getting her a watch with an audible alarm has turned into a nightmare because it isn't analog or it's too big. Even if we get her the perfect watch, we still foresee her setting down the medications after collecting them because she gets so easily distracted and sidetracked. There are too many "squirrels". This has happened with my brothers there. They give her 30 minutes to take her meds and if she doesn't remember she is reminded. Even if we set up Alexa devices, we know her too well, having observed her that she will shut them off and tell herself she will get the meds in a minute and then forget. She wants to continue to live independently and drive but she can't even prepare meals in a reasonable amount of time. Long term memory is great. Short term worse than before. Physically she does better than before the event. She has had an essential tremor for many years and noticed it gets worse with stress. I have noticed memory issues for at least a year but the hospitalization due to her lack of compliance scares me. Her safety is most important but mother is stubborn, doesn't want to part with her things and is quite easily falling back into her old ways not surprisingly. Results from the evaluation will be tomorrow. Her opinion of that, despite her acknowledging that she has some memory issues; is the neuropsychologist isn't an MD so it's just his opinion. She says doctors and health professionals are just consultants and she's ultimately the boss. Ugh! In-home speech therapist has been working with her once a week but my siblings and I have pretty much concluded she has dementia. There are many examples that lead us to that conclusion but we will know more tomorrow...not that it will change anything about our mom. So..sorry about the long story. There's just so much to try to take care of but med compliance is #1. Short of her hiring someone which she won't, we are at a loss. I've joked that she needs a drone medication dispenser that will follow her and nudge her when it's time to take her meds. Once we have the meds thing figured out, we are hoping to get her to sell her home and lots of her stuff and move into something more manageable and closer to me.
1) Convince her to move into a care facility where someone will supervise her taking her medications. She certainly won’t like this. If you have a POA perhaps you can force it. If she appears to be competent, the chances are that you can’t force her against her will. You may have similar problems with your plan to sell her home and move closer to you.
2) Accept that this situation will eventually kill her. Before you start screaming, remember that she has lived a long life by her own rules, and that all of us have to die. My husband and I have discussed the option of deliberately swapping up our meds (they do opposite things) to achieve a simple death. Missing the years after 80 is not all bad for her, for you and for the rest of the family.
Perhaps you give her the two options, gently but firmly, and let her make the choice.
I hope that someone else has suggestions that are a bit more palatable than this!
Your mother is correct (for now at least) on one point: she IS the boss. Until further notice the decisions are hers, and so are their consequences.
Family members are naturally concerned about loved ones' compliance and will go to all sorts of (sometimes questionable!) lengths to get those meds taken. We social care workers operate under different ethical constraints and must never coerce a client into taking medication. Some of my more experienced co-workers say things such as "your doctor has prescribed these for you, so they will be the correct meds for your condition and I am here to support you to take them." The last time I had a conversation with a client went a little differently, because she began to tell me the reasons why she didn't want to take her medication (usually it's nothing more than "shan't!" or "I'll do it later"). I would probably be in trouble if my line manager had heard me, but I ended up saying "no, I agree, you don't have to take them if you don't want to. It's your body, and these are your medications. But that is also your infected leg, and these antibiotics treat deep tissue wounds, and if you don't get rid of the infection you will not get better and you may end up back in hospital, and you cannot mess about with it. If you're not happy with any drug, speak to your doctor, don't just not take them." I was also able to sympathise with her because one of the meds I'd taken myself some years back and I can attest that it causes *satanic* heartburn! - I think my acknowledging that she wasn't just making a fuss about nothing might have been more helpful than any argument I could produce, and she did take her meds in the end.
Anyway, the point of this anecdote is that it sometimes pays to be blunt about consequences, and to focus more on the facts and less on your care and concern. Yes mother, it is up to you, and this is what will happen if you continue as you are, and x, y, and z are possible ways of avoiding it. Hey, it's not us who'll be back in ICU! This is your problem. You solve it.
Meanwhile... has she done anything about powers of attorney? Has she lined up a medical proxy or a DPOA? (I'm not sure I like to ask...)
A diagnosis would matter if your mom has created a PoA for herself. Her PoA should read the document to see when their authority is activated. Please be very sensitive and try not to make your mother feel "railroaded" out of her house and life. I realize your family needs to help her and you all may still have jobs and kids at home, but too much too fast will only make a difficult process more so. You are correct to take care of the medicine dispensing issue first however possible (hire someone to give them to her and watch her take them, then remove them so she can't take more by accident). I don't think an automated pill dispenser will work anymore. Someone has to physically hand her the pills and watch her swallow them. Dementia not only prevents you from learning new things, it eats away at what you used to know.
The caregiving arrangement only works if it works for both parties. Your mom needs help but your family can't continue to orbit around her constantly just to give her the illusion that she is independent (understanding she says she wants this). I think things may go somewhat better by not making too many changes all at once. How would you feel if you perceived your family was rapidly stripping away everything familiar? Even if it is for her own good, it doesn't change what it means and how it feels. Again, hoping she has a PoA.
I also thought the Guardian Freedom watch seemed really good but, being a lady, she might not like the looks.
Ultimately I tried a reminder watch because it was cheaper and we didn't need the fall monitoring features etc. Dad couldn't figure out what to do when there was an alarm and kept accidentally calling people not realizing he was connected. He may have more dementia than your mom though.
About the house. The thing that worked for me after YEARS of trying to get my dad to sell his house was one involving taxes. He had been living elsewhere for a couple of years and I told him time was running out for him to sell without capital gains tax! It didn't matter that the house he wasn't using was costing him a lot to just keep. It was storage for all his treasures. We packed up the best treasures and stored them. A few months later when we unpacked the treasures he had no memory of them to begin with! It's a process of many iterations of disposing of things, moving to a new life, buying appropriate things for the new life. I suspect there will be another move and more disposals in our near future.
Good luck!